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Introduction This study assessed the efficacy of the SinHumo App combined with a cognitive-behavioral smoking cessation treatment on 12-month follow-up abstinence, compared with the same smoking cessation treatment and a control App. Aims and Methods A sample of 288 treatment-seeking people who smoke were randomized: SinHumo App plus smoking cessation treatment (n = 140) and control App plus smoking cessation treatment (n = 148). The primary outcome was 7-day point prevalence abstinence (PPA) at the 12-month follow-up. Secondary outcomes were abstinence rates at the end of the intervention and 3- and 6-month follow-ups, cigarette per day (CPD) reduction over the 12-month follow-up, intervention engagement, and satisfaction. Results Intention-to-treat analyses showed nonsignificant differences in self-reported 7-day PPA at the 12-month follow-up (37.1 and 42.6%, respectively; OR = 0.80). No significant differences were found in abstinence at the end of the treatment (68.6 vs. 62.8%) nor on 7-day PPA at 3- (35.7 vs. 45.9%) and 6-month (35.0 vs. 41.2%) follow-up. Complete case and multiple imputation analyses yielded similar results for abstinence outcomes. A significant reduction in CPD across the 12-month follow-up in the subsample of participants who smoked was observed, but nonsignificant differences between conditions were found. Higher engagement with the SinHumo App was a significant predictor of 12-month abstinence. Satisfaction with the intervention was high and similar in both groups. Conclusions High abstinence rates over the 12-month follow-up and satisfaction were found in both conditions. The inclusion of the SinHumo App did not improve abstinence rates in the intervention. Implications Scarce research has examined the long-term efficacy of smoking cessation treatments, including Apps, to support the quitting process. The present randomized controlled trial contributes to the existing literature about including information and communication technologies i

A pesar de la importancia de las variables personales en los tratamientos psicológicos eficaces para dejar de fumar, son pocos los estudios que analizan los resultados de estos tratamientos en función de la edad de las personas que los demandan. En los últimos años ha habido un importante crecimiento de las Apps para dejar de fumar utilizadas como complemento a estos tratamientos. Sin embargo, la información disponible sobre cómo influye la edad en el proceso de dejar de fumar en intervenciones de este tipo es todavía escasa. El objetivo de la presente Tesis Doctoral fue evaluar la influencia de la edad, comparando personas de 18-44 años con personas de 45 años o más, en los resultados de un programa psicológico cognitivo-conductual para dejar de fumar con el apoyo de la App Non Fumo.

La utilización de APPs dentro de los programas para la mejora de la salud y estilos de vida son un recurso cada vez más extendido, dado su atractivo para el usuario y su gran accesibilidad. Por otro lado, fumar es la primera causa de morbi-mortalidad evitable en el mundo. A pesar de que en los últimos años ha disminuido el número de fumadores, todavía un número elevado de personas demandan tratamiento para dejar de fumar. El objetivo de la presente investigación es la utilización de una APP dentro de un programa psicológico para dejar de fumar bien establecido.

This review synthesizes the pharmacological and psychosocial interventions that have been conducted in comorbid bipolar disorder (BD) and substance use disorders (SUDs) while also providing clinical recommendations about which intervention elements are helpful for addressing substance use versus mood symptoms in patients with these co-occurring conditions. The best evidence from randomized controlled trials was used to evaluate treatment options. The strength of recommendations was described using the GRADE approach. Very few of the randomized trials performed so far have provided consistent evidence for the management of both mood symptoms and substance use in patients with a BD. No clinical trials are available for bipolar patients using cannabis. Some treatments have shown benefit for mood symptoms without benefits for alcohol or illicit substance use. Our results suggest that 1) we can (weakly) recommend the use of adjuvant valproate or naltrexone to improve symptoms of alcohol use disorder; 2) Lamotrigine add-on therapy seems to reduce cocaine-related symptoms and is therefore recommended (moderate strength); and 3) Varenicline is (weakly) recommended to improve nicotine abstinence. Integrated group therapy is the most-well validated and efficacious approach on substance use outcomes if substance use is targeted in an initial treatment phase, Esta revisión resume las intervenciones farmacológicos y psicosociales que se han realizado en trastorno bipolar (TB) y un diagnóstico comórbido de trastorno por uso de sustancias (TUS) y además proporciona recomendaciones clínicas respecto de cuáles elementos de intervención son útiles para hacer frente a los síntomas del uso de sustancias versus los síntomas de estado de ánimo en pacientes con estas afecciones concurrentes. Se utilizó la mejor evidencia de ensayos controlados aleatorizados para evaluar las opciones de tratamiento. La fuerza de las recomendaciones se describió mediante el enfoque GRADE. Muy pocos de los ensayos aleatorizados realizados hasta la fecha han proporcionado evidencia consistente para el manejo tanto de los síntomas de estado de ánimo como del uso de sustancias en pacientes con TB. No hay disponibilidad de ensayos clínicos para pacientes con TB que utilizan el cannabis. Algunos tratamientos han mostrado beneficios para los síntomas de estado de ánimo sin beneficios para el uso de alcohol o sustancias ilícitas. Nuestros resultados sugieren que 1) podemos (débilmente) recomendar el uso de ácido valproico o naltrexona adyuvante para aliviar los síntomas del trastorno por consumo de alcohol; 2) el tratamiento complementario con lamotrigina parece reducir los síntomas relacionados con la cocaína y, por tanto, es recomendable (fuerza moderada); y 3) la vareniclina es recomendable (débilmente) para mejorar la abstinencia de la nicotina. La terapia grupal integrada es el enfoque con más validación y eficacia sobre los resultados en el uso de sustancias cuando este uso es abordado durante la fase inicial de tratamiento

This study explores the shared and specific associations of brooding rumination and anxiety sensitivity to depression and anxiety symptomatology in a sample of treatment-seeking smokers. Methods: The sample was composed of 275 treatment-seeking adult smokers. Hierarchical linear regression analyses were conducted to examine the relations of both variables with depressive and anxiety symptoms. Results: Greater brooding rumination and anxiety sensitivity predicted higher levels of depression and anxiety symptoms. A specific relationship emerged after controlling for comorbid symptoms (depressive or anxiety symptoms) where brooding rumination was associated with depressive symptoms and anxiety sensitivity with anxiety symptoms. Conclusions: The findings showed that the variables examined are transdiagnostically related to emotional symptoms, but this relationship was symptomatology specific when controlling for comorbid symptoms (depressive or anxiety symptoms). Due to the impact of affective symptoms on abstinence outcomes, these findings have relevant clinical implications. In the context of smoking cessation treatment, identifying shared and specific vulnerabilities might contribute to tailoring and designing more precise and effective interventions for quitting smoking, Antecedentes: este estudio explora las asociaciones compartidas y específicas entre el factor reproches de la rumiación y la sensibilidad a la ansiedad con la sintomatología depresiva y ansiosa en una muestra de fumadores. Método: la muestra estaba formada por 275 fumadores adultos que demandaron tratamiento para dejar de fumar. Se realizó un análisis de regresión lineal jerárquica para examinar las relaciones de ambas variables con los síntomas depresivos y ansiosos. Resultados: mayores puntuaciones en rumiación-reproches y en sensibilidad a la ansiedad predijeron niveles más elevados de síntomas depresivos y ansiosos. Sin embargo, cuando se controlaron los síntomas comórbidos (depresivos o ansiosos), emergieron relaciones específicas entre la rumiación-reproches y los síntomas depresivos y entre la sensibilidad a la ansiedad y los síntomas ansiosos. Conclusiones: las variables examinadas se relacionan transdiagnósticamente con la sintomatología emocional, pero esta relación pasa a ser específica cuando se controlan los síntomas comórbidos (depresivos o ansiosos). Debido al impacto negativo que tienen los síntomas emocionales en la abstinencia, estos resultados pueden aportar implicaciones clínicas relevantes. La identificación de vulnerabilidades compartidas y específicas podría contribuir a adaptar y diseñar intervenciones más precisas y eficaces para dejar de fumar

Objectives: To assess the prevalence of active smoking and secondhand smoke (SHS) exposure among college students in the north of Portugal, and analyze the relationship between knowledge about tobacco use and attitudes toward smoking. Materials and methods: This a cross-sectional study with a representative sample of college students (n = 840) in one university in Portugal. A validated self-reported questionnaire was administered to a proportional stratified random sample during the academic year of 2018/2019. We evaluated associations between smoking status, SHS exposure, smokers peers, knowledge and attitudes toward smoking and sociodemographic variables. Results: The results showed that 20.1% of the students surveyed were current smokers (7.3% occasional smokers, 2.9% regular smokers and 9.9% daily smokers). Most current smokers started smoking before the age of 17 (61.4%) and reported never having tried to quit smoking (59.7%). Only 34.4% of students reported (almost) not having been in enclosed spaces with smokers in the past 7 days. Exposure to SHS and having smoker friends contributes to the prevalence of tobacco use. In general, students showed favorable attitudes toward smoking, especially those who are smokers, have smoking friends and are more exposed to SHS. The level of knowledge about tobacco was moderate, with a higher number of correct responses by former smokers

Introduction: Over the past sixty years, evidence for the adverse effects of chronic cannabis use has been demonstrated. Memory and concentration problems, the risk of schizophrenia in predisposed subjects, and amotivational syndrome have been referenced. There is not much doubt in relation to the first effect mentioned, but there is controversy around the last.Objective: To review the existing scientific evidence for the amotivational syndrome.Material and Methods: The review was conducted through academic database searching. The publications related to mental disorders associated with the chronic marijuana use, which referred to amotivational syndrome that fulfilled the criteria for articles attached to international standards, were taken into account.Results: A total of 31 articles were included. Of them, 16 presented the definition of amotivational syndrome. Once all the sources were integrated, the evidence found in 15 factors was organized. These factors included: apathy; disinterest; passivity; indifference; delay to perform tasks; sloth; presentism; reluctance to do prolonged activities that require attention or tenacity; abandonment of personal care; sexual disinterest; decreased reflexes; decreased self-efficacy; impairment in communication skills; social withdrawal, and unaltered affection.Conclusions: Based on these findings, we suggest that the amotivational syndrome is a constellation of symptoms and / or related signs which could constitute a typical morbidity caused by chronic cannabis use, so we expect that future research will be developed to demonstrate or discard their existence., Introducción: Durante los últimos sesenta años se ha construido evidencia sobre los efectos adversos relacionados con el consumo crónico de cannabis. Los problemas de memoria y concentración, el riesgo de esquizofrenia en sujetos predispuestos y el síndrome amotivacional han sido referenciados. Con los primeros al parecer no hay muchas dudas, pero en relación con el último, existe controversia.Objetivo: revisar la evidencia científica existente sobre el síndrome amotivacional.Material y Métodos: La revisión se realizó mediante una búsqueda en bases de datos académicas, se tomaron en cuenta las publicaciones que estuvieran relacionadas con trastornos mentales relacionados con el consumo crónico de marihuana en los que se hacía referencia al síndrome amotivacional que cumplieran con criterios de calidad de los artículos apegados a estándares internacionales.Desarrollo: Se incluyó un total de 31 artículos, de los cuales 16 incluían la definición de síndrome amotivacional. Una vez integradas todas las fuentes, se determinó organizar la evidencia encontrada en 15 factores: apatía; desinterés; pasividad; indiferencia; demora en la realización de tareas; pereza; presentismo; desgano para actividades prolongadas que requieran atención o tenacidad; abandono del cuidado personal; desinterés sexual; disminución de los reflejos; autoeficacia disminuida; deterioro de las habilidades comunicativas; retraimiento social y afecto no alterado.Conclusiones: A partir de los hallazgos, se sugiere que el síndrome amotivacional es una constelación de síntomas y/o signos relacionados, lo que podría constituir una morbilidad propia del consumo crónico de cannabis, se espera que en el futuro se desarrollen investigaciones que prueben o rechacen su existencia.

Introduction: Treatment completion is associated with abstinence outcomes in smoking cessation interventions. Previous research has stated that anxiety sensitivity (AS) is associated with smoking-related variables and smoking-cessation outcomes. To date, research has not examined the interaction between AS and treatment completion on smoking-cessation outcomes over time. This study aims to examine the main and the interactive effects of treatment completion and AS (total score and specific dimensions) on smoking-cessation outcomes at 3- , 6-, and 12-month follow-ups. Method: The sample consisted of 210 smokers enrolled in an eight-session smoking-cessation cognitivebehavioral treatment (62.1% women; Mage = 45.2, SD = 11.0). Participants were classified as completers (attended the eight treatment sessions) and non-completers (attended ≤ 7 sessions). Abstinence was biochemically confirmed. Results: Main effects indicated that completers had a higher likelihood of being abstinent over time when compared to non-completers. Regarding AS, those with greater AS-Physical Concerns had lower abstinence rates. Besides, a significant interaction between treatment completion, time and AS-Physical Concerns was found. Particularly, completers with greater AS-Physical Concerns had a higher likelihood of being abstainers than noncompleters over time, while no significant differences were found for those with lower AS-Physical Concerns. Conclusion: These data highlight the relevance of AS-Physical levels and smoking-cessation treatment completion on abstinence outcomes over time among treatment-seeking smokers

El consumo de drogas se ha convertido en un grave problema en las sociedades desarrolladas. En España, disponemos de datos fiables de consumo por las encuestas del Plan Nacional sobre Drogas, tanto en población de adolescentes (personas escolarizadas de 14 a 18 años), como en población general (personas de 15 a 65 años). La sustancia más consumida entre las drogas ilegales es el cannabis y sus derivados, seguida de la cocaína y el éxtasis. Destaca en los jóvenes el incremento del número de borracheras o consumo intensivo de alcohol y la participación en el botellón. En las últimas décadas se produjeron avances importantes en la conceptualización y desarrollo de programas preventivos eficaces. De la prevención primaria, secundaria y terciaria se ha pasado a la prevención universal, selectiva e indicada. Y, todo ello, ha facilitado recientemente el surgimiento de la prevención ambiental.

Smoking cessation interventions are effective, but they are not easily accessible for all treatment-seeking smokers. Mobile health (mHealth) apps have been used in recent years to overcome some of these limitations. Smoking cessation apps can be used in combination with a face-to-face intervention (FFSC-Apps), or alone as general apps (GSC-Apps). The aims of this review were (1) to examine the effects of FFSC-Apps and GSC-Apps on abstinence, tobacco use, and relapse rates; and (2) to describe their features. A systematic review was conducted following the internationally Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Of the total 6016 studies screened, 24 were included, of which nine used GSC-Apps and 15 FFSC-Apps. Eight studies reported significant differences between conditions in smoking cessation outcomes, with three of them being in favor of the use of apps, and two between different point-assessments. Concerning Apps features, most GSC-Apps included self-tracking and setting a quit plan, whereas most of the FFSC-Apps included self-tracking and carbon monoxide (CO) measures. Smartphone apps for smoking cessation could be promising tools. However, more research with an adequate methodological quality is needed to determine its effect. Nevertheless, smartphone apps’ high availability and attractiveness represent a great opportunity to reach large populations

The current study sought to further examine the relation between avoidance, environmental reward, depressive symptoms and cigarette dependence. Method: The sample included 275 adult treatmentseeking daily smokers (Mage = 45.36, SD = 10.96; 61.5% female). To examine the relationships between the study variables, correlation and serial mediation analyses were conducted. Results: A signifi cant positive relationship between cigarette dependence, avoidance, and depressive symptoms, and a negative relationship with environmental reward was found. Mediation analysis revealed a signifi cant indirect pathway from avoidance to cigarette dependence through depressive symptoms; and also a signifi cant indirect serial pathway from avoidance to cigarette dependence through environmental reward and depressive symptoms. Conclusions: Our fi ndings suggest the importance of avoidance, environmental reward and depressive symptoms in cigarette dependence. Our fi ndings contribute to the understanding of behavioral and psychological factors related to cigarette dependence, which is a well-known barrier to abstinence. Thus, it could be useful to assess and address such variables in the context of smoking-cessation interventions, Antecedentes: el presente estudio tiene como objetivo examinar la relación entre la conducta de evitación, el reforzamiento ambiental percibido, la sintomatología depresiva y la dependencia del tabaco. Método: la muestra estaba formada por 275 fumadores que demandan tratamiento para dejar de fumar (Medad = 45,36, DT = 10,96; 61,5% mujeres). Para examinar la relación entre las variables de estudio se realizaron análisis de correlación y de mediación serial. Resultados: se encontró una correlación positiva signifi cativa entre la dependencia del tabaco, la evitación y la sintomatología depresiva, y una correlación negativa signifi cativa con el reforzamiento ambiental percibido. El análisis de mediación serial reveló una vía indirecta signifi cativa entre la evitación y la dependencia del tabaco a través de la sintomatología depresiva; así como entre la evitación y la dependencia del tabaco a través del reforzamiento ambiental percibido y la sintomatología depresiva. Conclusiones: los resultados de este estudio contribuyen a la comprensión de factores conductuales y psicológicos implicados en la dependencia del tabaco, la cual es considerada una barrera para lograr la abstinencia. Por lo tanto, la evaluación y abordaje de estas variables podría considerarse un aspecto relevante en el contexto de las intervenciones para dejar de fumar

Relapse remains a frequent and complex phenomenon that is not yet well understood. An under-researched area of study that may provide relevant information concerns the assessment of specific post-treatment variables, rather than the composite measures commonly used to predict smoking relapse. The current study sought to examine the effects of post-treatment smoking-related variables, including withdrawal symptomatology, abstinence self-efficacy, and smoking urgency in negative-affect situations and smoking relapse at the 3 month follow-up. The sample comprised 130 participants who achieved abstinence for at least 24 h through a cognitive-behavioral smoking cessation treatment. Regression analysis was conducted for both composite measures and specific subscales and items. Data showed that composite measures of tobacco withdrawal, self-efficacy, and smoking urgency in negative-affect situations were not significant predictors of smoking relapse. However, the analysis including subscales, and specific items showed that lower self-efficacy in negative-affect-related situations (OR = 1.36) and three withdrawal symptoms—irritability/frustration/anger (OR = 2.99), restlessness/impatience (OR = 1.87), and craving (OR = 2.31)—were significant predictors of relapse. These findings offer new insights into the role of different smoking-related post-treatment variables in short-term relapse. Considering and specifically targeting these variables after achieving abstinence may potentially contribute to reducing smoking relapse

Smoking is the leading risk factor for quality of life, as well as for physical and psychological health. In fact, research has shown that tobacco use is closely related to depression. We present the assessment and intervention to quit smoking of a 49-year-old woman with depression and with a daily consumption of 15 cigarettes. A cognitive-behavioral intervention to quit smoking was applied with behavioral activation components for mood management. This intervention was carried out in eight individual sessions. At the end of the intervention, the participant quit smoking and remained abstinent at the follow-ups conducted throughout one year. She also showed a notable improvement in depressive symptomatology at short and long term after quitting. In conclusion, this intervention approach could be considered an adequate option to aid in the smoking cessation process and also to improve depressive symptoms, which implies a better quality of life and health, Fumar es uno de los factores de riesgo más importantes para la calidad de vida, así como para la salud física y psicológica de las personas. La evidencia de la que disponemos muestra que el consumo de tabaco está estrechamente relacionado con la depresión. En el presente artículo presentamos la evaluación e intervención psicológica para dejar de fumar de una mujer de 49 años de edad con depresión y con un consumo diario de 15 cigarrillos. Se aplicó una intervención psicológica de tipo cognitivo-conductual para dejar de fumar con componentes de activación conductual para el manejo del estado de ánimo. Dicha intervención se llevó a cabo en ocho sesiones individuales. Tras la intervención, la persona dejó de fumar y se mantuvo abstinente en los seguimientos realizados a lo largo del año siguiente, mostrando también una notable mejora en la sintomatología depresiva tanto a corto como a largo plazo. A modo de conclusión, este tipo de intervención psicológica podría considerarse una opción adecuada para dejar de fumar y para el manejo del estado de ánimo, logrando una mejora en el bienestar y salud de las personas.

Smoking is an important risk factor for health and quality of life, especially when there is a respiratory and/or cardiovascular disease. We present the evaluation and psychological intervention to quit smoking of a 41 years old male with severe physical illness and a daily consumption of 20 cigarettes and 5 small cigars. We applied a cognitive-behavioural smoking cessation program with six individual sessions. At the end of the psychological intervention the person quitted smoking and remained abstinent at 3, 6 and 12 months follow-ups, showing an improvement in the physical problems presented. We conclude that anyone can quit smoking with an appropriate psychological intervention thereby achieving a significant improvement in health, especially when there are severe physical problems., Fumar es uno de los factores de riesgo más importantes para la salud y calidad de vida de las personas, especialmente cuando está presente una enfermedad respiratoria y/o cardiovascular. Se presenta la evaluación e intervención psicológica para dejar de fumar de un varón de 41 años de edad con enfermedad física grave y con un consumo diario de 20 cigarrillos y 5 puritos. Se aplicó un programa cognitivo-conductual para dejar de fumar de seis sesiones individuales. Al final de la intervención psicológica la persona dejó de fumar y se mantuvo abstinente en los seguimientos realizados tras finalizar el tratamiento (a los 3, 6 y 12 meses), mostrando una mejora en los problemas físicos que presentaba. Se concluye que se puede dejar de fumar con una intervención psicológica adecuada logrando con ello una clara mejora en la salud, especialmente cuando se trata de personas con problemas físicos graves.

Fumar es uno de los factores de riesgo más importantes para la calidad de vida, así como para la salud física y psicológica de las personas. La evidencia de la que disponemos muestra que el consumo de tabaco está estrechamente relacionado con la depresión. En el presente artículo presentamos la evaluación e intervención psicológica para dejar de fumar de una mujer de 49 años de edad con depresión y con un consumo diario de 15 cigarrillos. Se aplicó una intervención psicológica de tipo cognitivo-conductual para dejar de fumar con componentes de activación conductual para el manejo del estado de ánimo. Dicha intervención se llevó a cabo en ocho sesiones individuales. Tras la intervención, la persona dejó de fumar y se mantuvo abstinente en los seguimientos realizados a lo largo del año siguiente, mostrando también una notable mejora en la sintomatología depresiva tanto a corto como a largo plazo. A modo de conclusión, este tipo de intervención psicológica podría considerarse una opción adecuada para dejar de fumar y para el manejo del estado de ánimo, logrando una mejora en el bienestar y salud de las personas, Smoking is the leading risk factor for quality of life, as well as for physical and psychological health. In fact, research has shown that tobacco use is closely related to depression. We present the assessment and intervention to quit smoking of a 49-year-old woman with depression and with a daily consumption of 15 cigarettes. A cognitive-behavioral intervention to quit smoking was applied with behavioral activation components for mood management. This intervention was carried out in eight individual sessions. At the end of the intervention, the participant quit smoking and remained abstinent at the follow-ups conducted throughout one year. She also showed a notable improvement in depressive symptomatology at short and long term after quitting. In conclusion, this intervention approach could be considered an adequate option to aid in the smoking cessation process and also to improve depressive symptoms, which implies a better quality of life and health

Introduction Behavioral Activation is a behavioral-based treatment that has been proposed as suitable for smoking cessation, as it simultaneously addresses reinforcement-related variables and also mood management. The aim of this study was to compare the effects of a cognitive-behavioral smoking cessation treatment with components of behavioral activation (SCBSCT-BA) with a standard cognitive-behavioral treatment (SCBSCT), and a wait-list control group (WL). Method The sample was comprised of 275 adults smokers (61.4% females, mean age = 45.36, SD = 10.96). After baseline assessment sessions, participants were randomized (ratio: 2.2.1.) to SCBSCT-BA, SCBSCT, or WL. Active groups received 8 weekly 1-hour face-to-face group sessions. Biochemically verified smoking abstinence and depressive symptoms were assessed at the end of treatment, and at 3-, 6-, and 12-month follow-ups. Results Significant treatment effects in 7-dayspoint prevalence abstinence rates were found for both active groups at the end of treatment. Abstinence rates at 12-months follow-up were 30% for SCBSCT-BA, and 18% for SCBSCT. Using Multiple Imputation for missing data, regression analysis showed significantly greater ORs for the SCBSCT-BA condition (vs. SCBSCT) at the end of treatment and at 3-months follow-up. At 6-, and 12-months follow-ups, ORs for the SCBSCT-BA condition, although greater, did not reach statistical significance. Multilevel analysis showed that abstinence was related to reductions in depressive symptoms. Conclusions SCBSCT-BA obtained positive results at short and medium term. Participants who quit smoking experienced a significant reduction in depressive symptoms. Findings support the benefit of adding BA to a cognitive-behavioral smoking cessation treatment

Fumar es uno de los factores de riesgo más importantes para la salud y calidad de vida de las personas, especialmente cuando está presente una enfermedad respiratoria y/o cardiovascular. Se presenta la evaluación e intervención psicológica para dejar de fumar de un varón de 41 años de edad con enfermedad física grave y con un consumo diario de 20 cigarrillos y 5 puritos. Se aplicó un programa cognitivo-conductual para dejar de fumar de seis sesiones individuales. Al final de la intervención psicológica la persona dejó de fumar y se mantuvo abstinente en los seguimientos realizados tras finalizar el tratamiento (a los 3, 6 y 12 meses), mostrando una mejora en los problemas físicos que presentaba. Se concluye que se puede dejar de fumar con una intervención psicológica adecuada logrando con ello una clara mejora en la salud, especialmente cuando se trata de personas con problemas físicos graves, Smoking is an important risk factor for health and quality of life, especially when there is a respiratory and/or cardiovascular disease. We present the evaluation and psychological intervention to quit smoking of a 41 years old male with severe physical illness and a daily consumption of 20 cigarettes and 5 small cigars. We applied a cognitive-behavioural smoking cessation program with six individual sessions. At the end of the psychological intervention the person quitted smoking and remained abstinent at 3, 6 and 12 months follow-ups, showing an improvement in the physical problems presented. We conclude that anyone can quit smoking with an appropriate psychological intervention thereby achieving a significant improvement in health, especially when there are severe physical problems

Background: In recent years, we have repeatedly been told that addictions are a brain disease, leaving aside their classic biopsychosocial explanation. Objective: To describe both models and discusses the weakness and reductionism of the brain disease model following the consumption of heroin by North American soldiers in the Vietnam war in the 1970s. Method: A literature review of the Vietnam Veteran Study in relation to drug consumption. Results: The soldiers greatly increased their consumption of heroin in Vietnam, but almost all of them ceased using it upon returning home. The analysis of the environmental factors related to this self-healing is a critique of the brain disease model of addictions because it cannot explain this or other studies. Conclusion: The biopsychosocial model is still the best model to guide the fi eld of addiction due to its utility, coherence, and effi cacy in treatment, Antecedentes: en los últimos años se escucha cada vez más la afi rmación de que las adicciones son una enfermedad cerebral, dejando a un lado la clásica explicación biopsico-social en adicciones. Objetivo: describir ambos modelos y analizar la debilidad y reduccionismo del modelo de enfermedad cerebral siguiendo el Vietnan Veteram Study, sobre el consumo de heroína, en los soldados norteamericanos que participaron en la guerra del Vietnam. Método: revisión de la literatura del Vietnam Veteran Study en relación al consumo de drogas. Resultados: los soldados incrementaron de modo importante el consumo de heroína en Vietnam, pero casi todos dejaron de consumirla a su vuelta a casa. Analizando los factores ambientales relacionados con esta auto-cura se hace una crítica del modelo de enfermedad cerebral en adicciones ya que el mismo no puede explicar este ni otros estudios. Conclusión: el modelo biopsicosocial sigue siendo el mejor modelo para el campo de las adicciones debido a su utilidad, coherencia y efi cacia en su tratamiento

Background: Previous studies have shown that smoking is associated with health-related quality of life (HRQoL) impairment. In order to evaluate HRQoL in a sample of Spanish relapsers, a cross-sectional study was conducted. Method: The sample was made up of 775 smokers who had relapsed after a period of abstinence. HRQoL was evaluated using the Euro-Qol questionnaire (EQ-5D); through the descriptive profi le, the EQ-5D index and the visual analogue scale (EQ-VAS). Results: Higher nicotine dependence was related to worse HRQL. According to the EQ-VAS, higher daily cigarette consumption and more years smoking were related to worse perceived health. In the EQ-5D those who had quit smoking in the previous year perceived worse health. Mobility and anxiety / depression are the dimensions affected by smoking. Those who are more nicotine dependent (OR = 2.29) and have been smoking for longer (OR = 4.12) are more likely to have mobility problems; and those who are nicotine dependent (OR = 1.85) and relapsed more than a year ago (OR = 0.63), are more likely to experience anxiety / depression. Conclusions: Nicotine dependence demonstrated a determining effect on HRQOL deterioration in smokers who have relapsed, Antecedentes: estudios previos demuestran que fumar produce un deterioro de la calidad de vida relacionada con la salud (CVRS). Para evaluar la CVRS en fumadores españoles que han recaído se realizó un estudio transversal. Método: la muestra estaba formada por 775 fumadores que habían recaído tras un período de abstinencia. La CVRS se evaluó mediante el cuestionario Euro-Qol 5D (EQ-5D), utilizando el perfi l descriptivo, el índice EQ-5D y la escala visual-analógica (EQ-EVA). Resultados: a mayor dependencia de la nicotina peor CVRS. En la EQEVA, a mayor consumo diario de cigarrillos y más años consumiendo, peor estado de salud percibido. En el EQ-5D los que dejaron de fumar en el último año son los que perciben peor estado de salud. Movilidad y ansiedad/depresión son las dimensiones afectadas en esta muestra de fumadores que han recaído. Es más probable que tengan problemas en movilidad los que tienen dependencia (OR = 2,29) y llevan más años fumando (OR = 4,12), y es más probable que presenten ansiedad/depresión los dependientes (OR = 1,85) y los que recayeron hace más de un año (OR = 0,63). Conclusiones: la dependencia de la nicotina mostró un efecto determinante en el deterioro de la CVRS en fumadores que han recaído

Smoking is the leading preventable cause of morbidity and mortality and has been linked with diseases such as cancer and cardiovascular diseases. The case of a 50-year-old woman with breast cancer, who suffered a stroke the previous month and is in treatment for depression and wants to quit smoking, is analyzed. She smoked 10 cigarettes a day and had never quit smoking. She received six sessions of a cognitive-behavioral psychological intervention to quit smoking. She stopped smoking and remained abstinent through the 1-year follow-up, showing a clear physical improvement and a significant reduction of depressive symptomatology (from 24 on the Beck Depression Inventory–II [BDI-II] before treatment to 1 at the 12-month follow-up). This indicates that, in many cases, smoking cessation produces an improvement not only in physical health but also in mood

Background Smoking is an important risk factor for mental health-related problems. Numerous studies have supported a bi-directional association between cigarette smoking and depression. Despite the advances in understanding the comorbidity between both problems, the most effective psychological treatment that simultaneously targets smoking and depressive symptomatology remains unclear. The objective of this study is to assess the effectiveness of a cognitive-behavioral intervention for smoking cessation with components of behavioral activation for managing depressed mood. Method A single blind, three-arm, superiority randomized controlled trial is proposed. Participants will be smokers over 18 years old, who smoke at least 8 cigarettes per day. Participants will be randomized to one of three conditions, using a 2:2:1 allocation ratio: 1) standard cognitive-behavioral smoking cessation treatment; 2) standard cognitive-behavioral smoking cessation treatment plus behavioral activation; or 3) a three-month delayed treatment control group. The primary outcome measures will be biochemically verified point-prevalence abstinence (carbon monoxide in expired air) and significant change from baseline in depressive symptoms to the end of treatment, and at the 3-, 6-, and 12-month follow-up. Discussion This study aims to assess the efficacy of a cognitive-behavioral intervention with behavioral activation components for smoking cessation and depressive symptoms, compared to a standard cognitive-behavioral intervention to quit smoking. As the relation between depressive symptoms, even at subclinical levels, and quitting smoking difficulties is well known, we expect that such intervention will allow obtaining higher abstinence rates, lower relapse rates, and mood improvement

We conducted a systematic literature review and meta-analysis (ID: CRD42016051017) of smoking cessation interventions for patients with current depression. We examined the effectiveness of smoking cessation treatments in improving abstinence rates and depressive symptoms. The following electronic databases were used for potentially eligible studies: PUBMED, PSYCINFO, DIALNET and WEB OF KNOWLEDGE. The search terms used were: smoking cessation, depressive disorder, depression, mood, depressive, depressed, smoking, smokers, nicotine, nicotine dependence, and tobacco cigarette smoking. The methodological quality of included studies was assessed using the Effective Public Health Practice Project Quality assessment tool (EPHPP). Of the 6,584 studies identified, 20 were eligible and included in the review. Trial designs of studies were 16 randomized controlled trials and 4 secondary studies. Studies included three types of intervention: psychological (6/30%), pharmacological (6/30%) or combined (8/40%). Four trials comprised special populations of smokers. Four studies received a strong methodological quality, 7 were scored as moderate and 9 studies received a weak methodological rating. Analyses of effectiveness showed that smoking cessation interventions appear to increase short-term and longterm smoking abstinence in individuals with current depression. Subgroup analyses revealed stronger effects among studies that provided pharmacological treatments than in studies using psychological treatments. However, the evidence is weak due to the small number of studies. Smoking abstinence appears to be associated with an improvement in depressive symptoms. Heterogeneity in protocols in similar types of treatment also prevent firm conclusions being drawn on the effectiveness of any particular treatment model to optimally manage abstinence among depressed smokers. Further research is required to strengthen the evidence base

En los últimos años se ha ido consolidando la idea en el campo médico-psiquiátrico de que la adicción es una “enfermedad cerebral”, como ya así recoge el DSM-5. En este articulo se analiza cómo ha surgido y se ha consolidado esta idea, las críticas que ha recibido, las consecuencias profesionales si este modelo se hace hegemónico, junto a los intereses subyacentes al mismo. Se concluye defendiendo la necesidad de mostrar como psicólogos nuestras claras aportaciones al campo de las adicciones, como el de las variables psicológicas que son necesarias para la comprensión de las adicciones, para su prevención, junto con el papel central del tratamiento psicológico por su eficacia en las mismas. También debemos denunciar los reduccionismos, como el que representa el modelo de enfermedad cerebral frente a un modelo biopsicosocial de las adicciones, The idea that addiction is a “brain disease” has gradually been consolidated in the medical-psychiatric field over the last years, as it appears in the current DSM-5. In this paper we analyse the way this idea has arisen and been consolidated, as well as the criticisms that it has received, the professional consequences if this model becomes hegemonic, and the underlying interests. The conclusion defends the need to show, as psychologists, our clear contributions to the field of addictions, and the psychological variables that are necessary in order to understand and prevent addictions, as well as the central role of psychological treatment due to its effectiveness. We must also denounce the reductionism that the model of brain disease represents in comparison with a biopsychosocial model of addiction

Background: There is consistent evidence about the relationship between smoking and mental health. This study compares the relationship between tobacco use and personality disorders (PDs) in Spanish adults from general and clinical population, taking into account nicotine dependence (ND), and the presence of any mental disorder. Method: The sample was made up of 1,079 smokers (519 from general population, 560 from clinical population). PDs were assessed by means of the International Personality Disorder Examination Questionnaire, Module DSM-IV. Results: Individuals seeking treatment to quit smoking had a higher likelihood of presenting a paranoid, schizoid, schizotypal, borderline, antisocial, and dependent PD compared to smokers from the general population. This likelihood was higher when ND was taken into account. Among smokers from the general population, ND was associated with a higher likelihood of presenting a borderline and dependent PD. Conclusions: A signifi cant relationship between smoking and several PDs exist, especially in nicotine dependent smokers. Relevance of the fi ndings regarding the infl uence of PDs in smoking cessation interventions is discussed, Antecedentes: existe evidencia sólida sobre la relación entre fumar y salud mental. Este estudio compara la relación entre consumo de tabaco y trastornos de personalidad (TP) en adultos españoles de población general y población clínica, teniendo en cuenta la dependencia de la nicotina (DN) y la presencia de algún trastorno mental. Método: la muestra estuvo formada por 1.079 fumadores (519 de población general, 560 de población clínica). Los TP se evaluaron con el cuestionario del International Personality Disorders Examination, Módulo DSM-IV. Resultados: los individuos que demandaron tratamiento para dejar de fumar tenían una mayor probabilidad de presentar un TP paranoide, esquizoide, esquizotípico, límite, antisocial y dependiente que los fumadores de población general. Esta probabilidad fue mayor cuando además existía DN. Entre los fumadores de población general, la DN se asoció con una mayor probabilidad de presentar un TP límite y dependiente. Conclusiones: existe una relación signifi cativa entre consumo de tabaco y varios TP, especialmente en fumadores dependientes de la nicotina. Se comenta la relevancia de los hallazgos respecto a la infl uencia de los TP en las intervenciones para dejar de fumar

Background: This study was aimed at: (i) examining levels of self-deception in substance dependent individuals following addiction treatment, and (ii) examining the association between participants’ levels of self-deception and (a) personality disorders, (b) addiction-related beliefs, (c) duration of abstinence, and (d) estimates of craving. Method: We administered self-report questionnaires of self-deception and mixtification, and core beliefs related to addiction and craving. The sample comprised 79 outpatients who were consecutively recruited at the Centro Provincial de Drogodependencias in Granada: 87.3% were males and the mean age was 37.68 years old. Thirty-four percent of participants were diagnosed with comorbid personality disorders. Results: Results showed that individuals with substance dependence exhibit elevated scores of self-deception, particularly in the domains of active denial, selective amnesia, projection, and confabulation. Individuals with comorbid personality disorders display greater levels of self-deception compared to individuals without dual diagnosis. Conclusions: Moreover, there is a significant association between levels of self-deception and addiction-related beliefs and craving. In addition, there is a negative association between levels of self-deception and duration of abstinence, Antecedentes: los objetivos de este estudio fueron: (i) conocer el nivel de autoengaño de drogodependientes en tratamiento por su adicción, y (ii) estudiar la relación del autoengaño con (a) los trastornos de personalidad, (b) las creencias, (c) la abstinencia y (d) el craving en estos pacientes. Método: se utilizaron los cuestionarios de autoengaño y mixtificación (IAM) y de creencias relacionadas con el consumo de drogas y craving. La muestra estaba compuesta por 79 pacientes atendidos de forma consecutiva en el Centro Provincial de Drogodependencias de Granada. El 34.5% de los pacientes presentaban un trastorno de la personalidad. Resultados: los resultados mostraron que los drogodependientes obtienen puntuaciones elevadas en autoengaño, especialmente en los factores negación, amnesia selectiva, proyección y pensamiento fantaseado. Además, los pacientes con trastornos de la personalidad presentan niveles de autoengaño más elevados en comparación a los que no presentan este tipo de psicopatología, observándose una relación significativa entre las creencias nucleares relacionadas con el consumo y con el craving con el nivel de autoengaño. Conclusiones: se constata igualmente que el nivel de autoengaño se relaciona de forma negativa con el tiempo de abstinencia, lo que convierte al autoengaño en una diana terapéutica para mejorar el pronóstico